One Application Per Household Only
Agrihood Senior Community will comply with the provisions of any federal, state or local law prohibiting discrimination in housing on the basis of race, color, creed, ancestry, national origin, sex, sexual orientation, familial status, source of income, age, disability, AIDS, or AIDS relation condition.
Please notify the business office if you need auxiliary aids such as large type face, information by audio tape, computer disk, Braille and/or in a language other than English. Best efforts will be made to accommodate such requests.
TDD Telephone device for the deaf only (415) 345-4470 or California Relay Service (711).
Please fill in all blanks. Incomplete applications will not be processed.
PLEASE NOTE: THIS FORM WILL NOT SAVE! We strongly advise the applicant (and all co-applicants, if applicable) to be present while completing this form. Please be ready to fill out all information as required while completing your housing application.
Indicate two people who generally know how to contact you:
List all household members who will be living in the residence. Give the relationship of each family member to the head of household.
Smoking is prohibited on the property, including but not limited to all units and common areas.
Please list at least two (2) years of rental history below.
CURRENT LANDLORD DETAILS
PREVIOUS LANDLORD DETAILS
Please carefully read and complete the rest of the form, then submit when ready.
John Stewart Company (the Company), as prospective landlord or property manager for the landlord, intends to seek and obtain information about you from a consumer reporting agency and/or an investigative consumer reporting agency for the purposes of qualifying you for a rental dwelling unit. As such, you can expect to be the subject of a "consumer report," "consumer credit report," and/or an "investigative consumer report" obtained for tenant screening purposes. Investigative consumer reports may include information about your character, general reputation, personal characteristics and/or mode of living. With respect to any investigative consumer report from an investigative consumer reporting agency ("ICRA"), the Company may investigate the information contained in your rental application and other background information about you, including but not limited to obtaining a criminal history, verifying references, employment history, social security number, educational history or status, licensure, and certifications, driving history, and other information about you, and interviewing people who are knowledgeable about you. The results of this consumer report may be used as a factor in determining your qualifications for the dwelling unit. The investigative consumer reporting agency preparing the report is: National Tenant Network (NTN); PO Box 6245; Concord, CA 94524; 1-800-800-5602; www.ntnonline.com.
The company agrees to provide you with a copy of a consumer report when required to do so under California law.
Under the California Civil Code 1786.10 you are entitled to find out from an ICRA what is in the ICRA's file on you with proper idenfication, as follows:
"Proper Identification" includes documents such as valid government issued license or ID, social security number, military identification card, and credit cards. Only if you cannot identify yourself with such information may the ICRA require additional information concerning your employment and personal or family history in order to verify your identity.
The ICRA will provide trained personnel to explain any information furnished to you and will provide a written explanation of any coded information contained in files maintained on you. This written explanation will be provided whenever a file is provided to you for visual inspection.
You may be accompanied by one other person of your choosing, who must furnish reasonable identification. An ICRA may require you to furnish a written statement granting permission to the ICRA to discuss your file in such person's presence.
I, the undersigned, hereby authorize, John Stewart Company (JSCo) as prospective landlord or property manager for the landlord, to seek and obtain any information pertinent to my income, credit history, tenancy history, employment history, and/or criminal history.
I understand this process may include the making of a Consumer Credit Report (as identified under California Civil Code 1785.3(c)) and/or an Investigative Consumer Report (as identified under California Civil Code 1786.2(c)), the contents of which may include information about my character, general reputation, personal characteristics and/or mode of living. The investigative consumer reporting agency preparing the report is:
National Tenant Network (NTN); PO Box 6245; Concord, CA 94524; 1.800.800.5602; www.ntnonline.com
For purposes of obtaining and/or verifying information contained in my application and pertinent to my qualification as a tenant of a JSCo managed property, this report may contain information obtained from national credit bureaus (Experian, TransUnion, Equifax), court records, files and/or repositories, department of justice (DOJ), department of corrections (DOC), department of motor vehicles (DMV), current and/or previous employer(s), current and/or previous landlord(s), business and/or personal references, or any other source necessary to verify the information I have provided on my application.
Further, I expressly consent to the release of any and all information requested of any creditors, credit reporting agencies, landlords, employers, public and/or criminal agencies subsequently contacted by JSCo/ National Tenant Network (NTN) for purposes of obtaining and/or verifying said information, and hereby hold the landlord, property manager for the landlord, National Tenant Network (NTN), and any responding parties harmless of liability for the seeking and providing of any such information contained in or pertinent to my application.
I understand I have the right to receive a free copy of the investigative consumer report prepared in accordance with my submitted application and this authorization by checking the box below:
You will receive a copy of the consumer investigative report prepared in accordance with this authorization.
Please send my copy to the following recipient at the following address:
Further, by signing below, I acknowledge receipt of the NOTIFICATION of INVESTIGATIVE CONSUMER REPORT.
Provided by National Tenant Network
You must place a “security freeze” with each consumer reporting agency to which you seek to prevent access. To request a security freeze from the major credit bureaus you may contact:
PO Box 9554
Allen, TX 75013
PO Box 6790
Fullerton, CA 92834
PO Box 105788
Atlanta, GA 30348
**If mailing your request for a credit freeze, requests must be sent by certified mail**
The Investigative Consumer Reporting Agencies Act (ICRA) is designed to promote accuracy, fairness and privacy of information in the files of every “consumer reporting agency” (CRA). You will find the complete text of the ICRA at https://leginfo.legislature.ca.gov. The ICRA gives you specific rights as outlined below. You may have additional rights under federal law. Contact your state or local consumer protection agency or your state Attorney General’s Office to learn those rights.
An investigative consumer reporting agency hereinafter referred to as “Agency” will supply files and information that you have a right to inspect during normal business hours and upon reasonable notice.
All files the Agency maintains on you will be made available for your visual inspection as follows:
“Proper identification” includes documents such as a valid driver’s license, social security number, military identification card, and credit cards. Only if you cannot identify yourself with such information may the Agency require additional information concerning your employment and personal or family history in order to verify your identity.
You may have additional rights under Federal law. For more information, contact your state or local consumer protection agency or your state Attorney General’s office.
The Federal Fair Credit Reporting Act (FCRA) is designed to promote accuracy, fairness and privacy of information in the files of every consumer reporting agency (CRA). There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). The FCRA gives you specific rights as outlined below. For more information, including information about additional rights, visit www.consumerfinance.gov/learnmore or write to the Consumer Financial Protection Bureau; 177 G Street, NW; Washington, DC 20552. You may have additional rights under state law. Contact your state or local consumer protection agency or your state Attorney General’s Office to learn those rights.